Pregnant women and infants against the infection risk of COVID-19: a review of prenatal and postnatal symptoms, clinical diagnosis, adverse maternal and neonatal outcomes, and available treatments.

BACKGROUND: The establishment of a risk-appropriate care approach for pregnant women and newborn infants under the COVID-19 pneumonia is vital to prevent the main pregnancy complications. OBJECTIVES AND DESIGN: This study reviewed the vertical transmission (VT) potential of COVID-19 pneumonia in pregnant women. Key-related symptoms and adverse clinical outcomes for mothers and infants before and after childbirth were summarized. Some practical therapies and preventive health solutions were also proposed. RESULTS: There was a high susceptibility in pregnant women to COVID-19 infection, especially in the third trimester of pregnancy. The most common symptoms in 22-40-year-old patients infected with COVID-19 were fever (87.6%), cough (52.3%), dyspnea (27.6%), fatigue (22.4%), sore throat (13.5%), malaise (9.4%), and diarrhea (3.4%), respectively. The viral infection led to an increase in preterm labor and cesarean delivery without any intrauterine infection and severe neonatal asphyxia. No infection in the newborn infants was reported despite a high risk of the VT phenomenon. The most important therapies were the reception of antiviral and antibiotic drugs, oxygenation therapy, psychological interventions, and food supplements with health-promoting effects. The best proposed medical strategies to control the COVID-19 infection were bi-monthly screening and following-up the mothers' and fetuses' health, not using the potent broad-spectrum antibiotics and corticosteroids, providing the delivery room with negative pressure for emergency cesarean section, and the immediate isolation of newborns after childbirth without direct breastfeeding. CONCLUSION: Babies with respiratory problems may be born to some mothers with COVID-19, who have weak immune systems. Thus, the virus transmission cycle should be disrupted to prevent adverse maternal and fetal outcomes by integrating individual health guidelines, efficient medical care therapies, and hospital preventive practices.

Decreasing the main maternal and fetal complications in women undergoing in vitro fertilization (IVF) trained by nutrition and healthy eating practices during pregnancy.

PURPOSE: In vitro fertilization (IVF) can lead to undesirable consequences for pregnant women and their newborns. Reducing the adverse maternal (mainly, gestational diabetes mellitus (GDM) and preeclampsia (PE)), and fetal outcomes in IVF-pregnant women (IVF-PW) was aimed with the correct training of nutrition principles during pregnancy. MATERIALS AND METHODS: A quasi-experimental clinical trial with 170 IVF-PW in intervention and control groups was conducted. The subjects before the dietary intervention completed questionnaires of nutritional and lifestyle and 24-h food recall. The intervention group was trained with the diet modification programs from early (12-16 weeks) to late (week 34) pregnancy in six weekly, 15-20-min sessions. The GDM diagnosis was based on 75-g OGTT and FBS tests, respectively, in 24-28 weeks' gestation. Other adverse maternal (e.g. PE, cesarean delivery, and preterm delivery (<37 weeks)), and fetal (e.g. intrauterine growth retardation (IUGR), birth weight, and fetal viability) outcomes were also monitored. The dataset was assessed using both inferential and descriptive statistics. RESULTS: A diet modification program with an increased intake of lactose, fiber, and some minerals (e.g. magnesium and zinc) and vitamins (e.g. B3 and B5) in conjunction with a lower intake rate of glucose and lipid could control the prevalence of adverse maternal and neonatal outcomes in IVF-PW. Although the GDM reduction in the two intervention (8.2%) and control (20.0%) groups was statistically insignificant, there was a significant difference in PE prevalence at a lower rate (39.0%) in the intervention group than the control. No significant difference in cesarean delivery (94.1-95.2%), and preterm delivery (45.9%) between the two groups was found. The IUGR (24.7-25.9%), birth weight (2.791-2.820 kg), and fetal viability (95.3-97.6%) also did not change significantly after the healthy eating practices during pregnancy. CONCLUSIONS: Diet-based interventions in IVF-PW during pregnancy were efficient in improving the outcomes for both mother and baby.

Reducing the Adverse Maternal and Fetal Outcomes in IVF Women by Exercise Interventions During Pregnancy.

Purpose: The role of a structured program of exercise training on the low-risk pregnancy in Iranian women undergoing in vitro fertilization (IVF) based on the reduction of gestational diabetes was examined. Method: A comparative quasi-experimental clinical trial with 170 IVF-pregnant women in two intervention and control groups was studied to monitor the training effect of physical activities in terms of walking, and aerobic, strength-conditioning, and relaxation exercises during pregnancy on the improvement of maternal and fetal health. Gestational diabetes as the main complication was evaluated with 2-h 75-g OGTT and FBS tests in 24-28 and 34- weeks' gestation, respectively. Other adverse maternal (e.g., preeclampsia, cesarean section, and preterm delivery) and neonatal (e.g., intrauterine growth retardation, low/high birth weight, and fetal death) outcomes were determined and analyzed by statistical and regression tests. Results: A significantly lower gestational diabetes and preeclampsia rate was found in the intervened IVF-pregnant women with the maintenance of an active lifestyle. Although there was no significant difference in other negative maternal and neonatal outcomes between the two groups, lower symptoms from these complications were recorded in IVF-pregnant women trained with regular exercise activities. Conclusion: Implementing the physical activity program by IVF-women during pregnancy is an effective intervention strategy in reducing the risk of adverse maternal and fetal outcomes.